- Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents.
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Il Suh, Chung Mo Nam, Sun Ha Jee, Suk Il Kim, Young Ok Kim, Sung Soon Kim, Won Heum Shim, Chun Bae Kim, Kang Hee Lee, Jong Won Ha, Hyung Gon Kang, Kyung Won Oh
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Korean J Prev Med. 1997;30(2):308-326.
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 Abstract
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- Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. a A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic diastolic BP at age 12 and 16 years old were 108.7 mmHg & 118.1 mmHg(systolic), and 69.5 mmHg & 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg & 113.5 mmHg(systolic) and 75.2 mmHg & 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index etc) increased consitantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend for females. Total fat intake increased at age 16 years compared with that at age 14 years. Composition of carbohydrate, protein and fat among total energy intake was 65:15:20 at age 14 and 16 years. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness, showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.
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Summary
- Four-year change and tracking of serum lipids in Korean adolescents.
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Kang Hee Lee, Il Suh, Sun Ha Jee, Chung Mo Nam, Sung Soon Kim, Won Heum Shim, Jong Won Ha, Suk Il Kim, Hyung Gon Kang
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Korean J Prev Med. 1997;30(1):45-60.
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- It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes and girls. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probability of remaining at the same group was more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in he future to investigate the long-term change of lipids from adolescents to adults.
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Summary
- A Study on Workers Exposed to Diatomaceous Earth Dust and Development of Pneumoconiosis in a Diatomite Factory.
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Hyun Suk Lim, Sung Soon Kim, Won Jae Lee
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Korean J Prev Med. 1995;28(1):1-12.
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- Diatomaceous earth, quarried from the remains of aquatic plants deposited millions of years ago, continues to be a very important raw material with many industrial uses. In its natural state diatomaceous earth is an amorphous silica with no crystalline pattern. For many uses, however, it is calcinated and calcination converts a portion of the amorphous silica to a crystalline form, cristobalite which is far more fibrogenic. In a factory which produces calcinated diatomaceous earth, seven workers were proved as pneumoconiosis on l991 and 1992. Authors reviewed medical chart and current status of them. Authors also examined thirty one subject from the factory with questionnaire, physical examination, spirometry and chest radiography on August 13th 1993. The radiographs were independently interpreted by two radiologists and their findings were classified by International Classification of Radiography of pneumoconiosis(lLO, 1980). Total and respirable dust of diatomaceous earth were measured on october 1993. The results were as follows: 1.Of 31 workers, 6 (19.4%) were diagnosed as diatomaceous earth pneumoconiosis. There was an increasing tendency in prevalence of pneumocoiosis as the duration of dust exposure gets longer. 2. There were no significant differences in age, smoking rate, alcohol drinking rate, and pulmonary function test results between cases and non-cases. 3. The means of total dust exposures at flour manufacturing, fire brick grinding and packaging, ceramic raws packaging processes exceeded Korean and AGGIH standards, 10mg/m3. Above results suggest that engineering controls, periodic environmental and medical surveillance are important for preventing pneumoconiosis in the diatomite factory.
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